Background: With respect to low prevalence of immunocompromised infectious diseases and their related difficulties in diagnosis and treatment, in the present study we review our experience with 3 adult and 3 infant patients with rhinocerebral mucormycosis. Materials and methods: Initial data including demographic features, clinical, laboratory and radiologic manifestations, therapeutic approach and clinical course of 6 cases of rhinocerebral mucormycosis were reviewed. Three patients died and 3 improved. Conclusion: Diabetes mellitus and metabolic cirrhosis were the most common predisposing factors. Rhinocerebral manifestations were present in all patients. Biopsy was the gold standard for diagnosis and the most efficient therapeutic approach is appropriate usage of immunosuppressive agents.

Mucormycosis is the most fatal systemic fungal disease which is precipitated by diabetes or immunodeficiency state. The most common form of the disease is the rhinocerebral involvement. The disease has a high rate of mortality if not diagnosed in time and treated properly. This article presents Mucormycosis in a diabetic. The case was a 26 year old young male with diabetes mellitus being treated with insulin; who was presented with fever, facial and right eye swelling, general bad condition, having a 3 year history of heroin (crystal) addiction, and referred with initial diagnosis of cellulites. On examination, it was found that the case had right eye proptosis and ecchymossis, unilateral bloody discharge of nose and dispnea.Moreover, black necrotic lesion was found in nasal mucosa. Biopsy of necrotic tissue was done and staining with PAS was performed, which proved the existence of rhinocerebral mucormycosis. The patient was taken to ICU and was Administered broad spectrum antibiotic treatment and 1mg/kg amphotericin B. But the next day, in spite of the treatment, the patient got dementia and deceased three days later.

Background & Objective: Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage. Methods: In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and facial nerve dysfunction,they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid–, Schiff (PAS) staining methods to rule out mucormycosis. Results: In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy,also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago). Conclusion: COVID-19 infection might be a predisposing factor for many opportunistic infections, such as fungal elements),thus, the physician should be aware of the dosage and duration of corticosteroid therapy to prevent the development of these infections.

Background: Rhino cerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery. Materials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied. Results: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1) facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2) involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3) involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients. Conclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients.